国际麻醉学与复苏杂志
國際痳醉學與複囌雜誌
국제마취학여복소잡지
INTERNATIONAL JOURNAL OF ANESTHESIOLOGY AND RESUSCITATION
2014年
2期
131-133,157
,共4页
张玉龙%夏闵涛%王义琛%浦江
張玉龍%夏閔濤%王義琛%浦江
장옥룡%하민도%왕의침%포강
地佐辛%术后自控静脉镇痛%腹部手术
地佐辛%術後自控靜脈鎮痛%腹部手術
지좌신%술후자공정맥진통%복부수술
Dezocine%Patient-controlled intravenous analgesia%Abdominal operation
目的 探讨不同剂量的地佐辛用于腹部大手术后患者自控静脉镇痛(patient-controlled intravenous analgesia,PCIA)的临床疗效和最适有效剂量.方法 将拟行腹部大手术美国麻醉医师协会(ASA)分级Ⅰ或Ⅱ级的患者60例按照随机数字表分为A、B、C3组,每组20例.术毕前20 min患者均静脉注射地佐辛0.12 mg/kg负荷量,术后均行PCIA,镇痛液中地佐辛含量分别为0.012 mg·kg-1·h-1(A组)、0.014 mg·kg-1·h-1(B组)、0.016 mg·kg-1·h-1(C组).观察术后6、12、24、48 h疼痛视觉模拟评分(visual analogue scores,VAS)、Ramsay评分、镇痛药液消耗量、总按压次数和有效按压次数,并记录术后恶心呕吐、头晕、呼吸抑制等副作用.结果 术后6、12、24、48 h VAS评分,C组[(1.8±1.1)、(1.5±0.8)、(1.3±0.9)、(1.1±0.9)]明显低于A组[(3.0±1.1)、(2.4±0.9)、(2.0±0.7)、(1.8±0.8)]与B组[(2.8±1.0)、(2.3±0.6)、(1.8±0.8)、(1.7±0.7)](P＜0.05).术后6、12 h Ramsay评分,C组[(2.2±0.6)、(2.3±0.6)]显著高于A组[(1.7±0.7)、(1.8±0.6)]和B组[(1.8±0.6)、(1.9±0.6)](P＜0.05).术后48 h内A、B组的患者自控镇痛(patient controlled analgesia,PCA)总按压次数、有效按压次数及镇痛药液消耗量明显高于C组(P＜0.05),C组镇痛总体满意度优于A、B组(P＜0.05).3组副作用发生率比较差异无统计学意义.结论 地佐辛0.016 mg·kg-1·h-1用于腹部手术后PCIA效果较好,不增加副作用发生率.
目的 探討不同劑量的地佐辛用于腹部大手術後患者自控靜脈鎮痛(patient-controlled intravenous analgesia,PCIA)的臨床療效和最適有效劑量.方法 將擬行腹部大手術美國痳醉醫師協會(ASA)分級Ⅰ或Ⅱ級的患者60例按照隨機數字錶分為A、B、C3組,每組20例.術畢前20 min患者均靜脈註射地佐辛0.12 mg/kg負荷量,術後均行PCIA,鎮痛液中地佐辛含量分彆為0.012 mg·kg-1·h-1(A組)、0.014 mg·kg-1·h-1(B組)、0.016 mg·kg-1·h-1(C組).觀察術後6、12、24、48 h疼痛視覺模擬評分(visual analogue scores,VAS)、Ramsay評分、鎮痛藥液消耗量、總按壓次數和有效按壓次數,併記錄術後噁心嘔吐、頭暈、呼吸抑製等副作用.結果 術後6、12、24、48 h VAS評分,C組[(1.8±1.1)、(1.5±0.8)、(1.3±0.9)、(1.1±0.9)]明顯低于A組[(3.0±1.1)、(2.4±0.9)、(2.0±0.7)、(1.8±0.8)]與B組[(2.8±1.0)、(2.3±0.6)、(1.8±0.8)、(1.7±0.7)](P＜0.05).術後6、12 h Ramsay評分,C組[(2.2±0.6)、(2.3±0.6)]顯著高于A組[(1.7±0.7)、(1.8±0.6)]和B組[(1.8±0.6)、(1.9±0.6)](P＜0.05).術後48 h內A、B組的患者自控鎮痛(patient controlled analgesia,PCA)總按壓次數、有效按壓次數及鎮痛藥液消耗量明顯高于C組(P＜0.05),C組鎮痛總體滿意度優于A、B組(P＜0.05).3組副作用髮生率比較差異無統計學意義.結論 地佐辛0.016 mg·kg-1·h-1用于腹部手術後PCIA效果較好,不增加副作用髮生率.
목적 탐토불동제량적지좌신용우복부대수술후환자자공정맥진통(patient-controlled intravenous analgesia,PCIA)적림상료효화최괄유효제량.방법 장의행복부대수술미국마취의사협회(ASA)분급Ⅰ혹Ⅱ급적환자60례안조수궤수자표분위A、B、C3조,매조20례.술필전20 min환자균정맥주사지좌신0.12 mg/kg부하량,술후균행PCIA,진통액중지좌신함량분별위0.012 mg·kg-1·h-1(A조)、0.014 mg·kg-1·h-1(B조)、0.016 mg·kg-1·h-1(C조).관찰술후6、12、24、48 h동통시각모의평분(visual analogue scores,VAS)、Ramsay평분、진통약액소모량、총안압차수화유효안압차수,병기록술후악심구토、두훈、호흡억제등부작용.결과 술후6、12、24、48 h VAS평분,C조[(1.8±1.1)、(1.5±0.8)、(1.3±0.9)、(1.1±0.9)]명현저우A조[(3.0±1.1)、(2.4±0.9)、(2.0±0.7)、(1.8±0.8)]여B조[(2.8±1.0)、(2.3±0.6)、(1.8±0.8)、(1.7±0.7)](P＜0.05).술후6、12 h Ramsay평분,C조[(2.2±0.6)、(2.3±0.6)]현저고우A조[(1.7±0.7)、(1.8±0.6)]화B조[(1.8±0.6)、(1.9±0.6)](P＜0.05).술후48 h내A、B조적환자자공진통(patient controlled analgesia,PCA)총안압차수、유효안압차수급진통약액소모량명현고우C조(P＜0.05),C조진통총체만의도우우A、B조(P＜0.05).3조부작용발생솔비교차이무통계학의의.결론 지좌신0.016 mg·kg-1·h-1용우복부수술후PCIA효과교호,불증가부작용발생솔.
Objective To investigate the analgesic effect of different doses of dezocine on a patient-controlled intravenous analgesia(PCIA) for pain control after major abdominal surgery.Methods Sixty patients (ASA Ⅰ orⅡ) undergoing major abdominal surgery were randomly divided into three groups of A,B,and C (n=20).Patients received a dezocine loading dose of 0.12 mg/kg at 20 min before the end of surgery.The background infusion of dezocine is 0.012,0.014 mg·kg1·h1 and 0.016 mg·kg1·h-1 in group A,B,and C,respectively.Visual analogue scores (VAS),Ramsay score,the analgesic consumption,the total number of patient controlled analgesia (PCA),the effective number of PCA,and the side effects (nausea,vomiting,dizziness and respiratory depression) were recorded at 6,12,24,48 h postoperatively.Results At 6,12,24,48 h postoperatively,the VAS scores in group C [(1.8±1.1),(1.5±0.8),(1.3±0.9),(1.1±0.9)] were significantly lower than those of group A[(3.0±1.1),(2.4±0.9),(2.0±0.7),(1.8±0.8)] and B [(2.8±1.0),(2.3±0.6),(1.8±0.8),(1.7±0.7)](P＜0.05).Meanwhile,the Ramsay scores were higher in group C[(2.2±0.6),(2.3±0.6)] than those in group A [(1.7±0.7),(1.8±0.6)] and B[(1.8±0.6),(1.9±0.6)](P＜0.05) at 6 h and 12 h after surpery.The scores of satisfaction of postoperative analgesia,analgesic consumption,the total and effective number of PCA were also lower in group C than the other groups (P＜0.05).Moreover,there is no statstical difference on the incidence of adverse effects among the three groups.Conclusions Patient-controlled intravenous analgesia with 0.016 mg·kg-1·h-1 dezocine shows the best analgesic effect,and the similar incidence of side effects.
